MitraClip

Man-and-dog-MitraClip.JPGPut your heart into trusted hands

A higher quality of care leads to a better quality of life. That’s why our minimally-invasive MitraClip procedure is designed to greatly reduce the symptoms of heart valve disease such as shortness of breath, and is an alternative for those who may not be a good candidate for heart surgery.

MitraClip is a catheter-based technology that uses a small clip attached to the mitral valve in the heart to treat mitral regurgitation or value leaking. MitraClip allows the mitral valve to close more completely, helping to restore normal blood flow through the heart.
 
Call our Northern Light Structrual Heart Program today for more information at 207.973.8054.

Watch this video to learn more about the MitraClip procedure.

 

GettyImages-1336434136.jpgLet’s talk about how your heart works. Your heart beats thousands of times per day, pumping dozens of gallons of blood each hour. It pumps blood through your lungs, where the blood is replenished with oxygen, and pumps it back out to the rest of your body.
 
The heart has four chambers; the upper two chambers are called the left atrium and right atrium, and the lower two are called the left ventricle and right ventricle.
Heart valves are the doorways between these chambers. They open to let blood pass from one chamber to the next, closing quickly between heartbeats so blood does not flow backward.
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Definition of Mitral Valve
The mitral valve is the valve between the left atrium and left ventricle of your heart. In a normally functioning mitral valve, blood flows in a single direction between the left atrium and left ventricle. When your mitral valve’s two leaflets (or flaps) do not close properly, some blood flows backward through the valve back into the left atrium. This is called mitral regurgitation (or MR).

To compensate and keep blood flowing through the body, the left ventricle pumps harder. This strain can lead to other heart complications.

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There are two types of mitral regurgitation (MR)
One type of mitral regurgitation is called primary MR (also called degenerative or organic). It is caused by an abnormality in the mitral valve itself. Primary MR can be related to age, a valve abnormality present from birth, heart disease, coronary artery disease, or a history of rheumatic fever. The other type is called secondary (or functional) MR. It is caused by heart disease that leads to an enlarged left ventricle. Patients with MR can be good candidates for the MitraClip procedure.

Symptoms of mitral regurgitation:
  • Shortness of breath
  • Fatigue
  • Coughing, dry hacking cough
  • Excessive urination
  • Lightheadedness, fainting
  • Swollen feet or ankles
  • Excessive urination
  • Inability to exercise
  • Decrease in appetite
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Our minimally invasive MitraClip procedure is designed to greatly reduce the symptoms of mitral regurgitation ​and heart valve disease such as shortness of breath and is an alternative for those who may not be a good candidate for heart surgery. This procedure can also help patients who have weak heart pumping function, experience less heart failure.

Your doctor will introduce the system through a vein in the groin area and it will be advanced to reach the heart. The MitraClip implant will be guided from the right atrium to the left atrium and then ultimately to your mitral valve through the catheter.

Your doctor will implant the MitraClip at the appropriate position on your mitral valve. The MitraClip will grasp the mitral valve leaflets to close the center of the mitral valve and reduce mitral regurgitation. Once the MitraClip is in place and working properly, the MitraClip Delivery System and the Steerable Guide Catheter will then be removed from your body. The implanted MitraClip will become a permanent part of your heart, allowing your mitral valve to close more tightly and reduce the backward flow of blood.

Benefits - Minimally invasive, catheter based procedure
Transcatheter mitral valve repair is a U.S. approved, minimally invasive treatment to repair your leaking mitral valve using an implanted clip. The entire system is introduced through a vein in the groin area and advanced to the heart.
  • Minimally invasive - This procedure does not require opening the chest or temporarily stopping the heart.
  • Quick procedure - The implantation procedure typically lasts 1 to 3 hours.
  • Short hospital stay - Patients are usually released from the hospital within 1 to 3 days, significantly less time compared to surgery.
  • 51% reduced risk of heart failure hospitalization
  • 2.5X more likely to experience a large improvement in health-related quality of life.
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Pictured below, you can see the size of the clip, as small as a dime.


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BEFORE - Preparing for a MitraClip Procedure
  • Take all your medications as instructed by your healthcare provider
  • Tell your doctor if you are taking any other medications.
  • Make sure your doctor knows of any allergies you have.
  • Follow all instructions given to you by your doctor or nurse.

DURING - During the MitraClip procedure
  • The procedure will likely be performed in a specialized room called a “cath lab.”
  • You will be placed under general anesthesia to put you in a deep sleep.
  • Your doctor will use x-ray and echocardiography to visualize your heart.
  • On average, the procedure will take between 1 to 3 hours.
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AFTER - After your MitraClip procedure 
  • Your hospital stay after the procedure will likely range from 1 to 3 days.
  • Your physician might prescribe cardiac rehab to improve your recovery time.
  • Your medications may change slightly after your procedure. Follow the instructions of your healthcare provider. 
  • You will be discharged to the care of your cardiologist or family doctor.

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Recovery -  it’s good to be back home, but remember to take time to recover.

Take it easy - it’s important not to strain yourself as you recover.
  • Avoid lifting heavy objects and doing strenuous exercise until your doctor says it’s safe. You can walk a short distance on level ground, but nothing more challenging than that
  • Do not go up and down the stairs more than 2 times per day—at least for the first 2 to 3 days
  • Avoid driving until your doctor says it’s safe
  • Eat heart-healthy foods, including fruits, vegetables, and low-fat options
Tend to your wound - take care of the area where the catheter was inserted.
  • Keep your wound dry for the first 24 hours
  • If you take a shower, avoid getting water on the wound
  • Do not take a bath or go swimming for at least 1 week
  • If bruising around the wound suddenly gets bigger or harder:
    • Call your doctor immediately
    • Lie down and apply pressure to the area just above the wound for 15 minutes (this should stop the bleeding) For safety, lie down for 2 or more hours
Call for help if needed - contact your doctor or emergency services. Have those important phoneGrandmother-lifting-up-two-year-old-and-touching-noses.jpg numbers handy, always.
  • You experience an increase in shortness of breath or sudden chest pain that doesn’t go away with rest or medication
  • You feel dizzy, very tired or faint, or have a fever
  • You have weight gain greater than 2lbs overnight
  • You cannot keep taking your medications because of side effects, such as rash, bleeding, or upset stomach
  • Before any medical or dental procedure; you may need to be prescribed antibiotics to avoid potential infection
  • The wound site is bleeding, becomes swollen, red, painful or has yellow or green discharge

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How does my doctor determine if I have mitral regurgitation?
To determine if you have mitral regurgitation and to assess the function and condition of your heart and mitral valve, your cardiologist may perform diagnostic evaluations including:
  • Taking a chest x-ray to see the size and shape of your heart and evaluate your lungs
  • Evaluating you for symptoms of congestive heart failure (such as shortness of breath or fatigue) or other related heart conditions

How will my doctors decide if I am a candidate for the MitraClip procedure?
You will be evaluated by a specially trained heart team at a MitraClip treating center, including a cardiac surgeon and a cardiologist, who will review your medical history and perform a variety of tests. There are several factors they will take into consideration when deciding whether or not you are too sick for heart surgery, and therefore a possible candidate for MitraClip therapy, such as your age, frailty, and the condition of your heart.

What is the MitraClip device made of?
The MitraClip device is a small metal clip covered with a polyester fabric that is implanted on your mitral valve. The clip is inserted through a catheter, without the need to temporarily stop your heart. There can be up to 4 different clip sizes used to tailor your clip size to your valve.

How long before I feel the effects of the MitraClip procedure?
Clinical data from patients who underwent the MitraClip procedure demonstrate an immediate reduction of mitral regurgitation. You should experience significant improvement in your symptoms of mitral regurgitation and quality of life soon after your procedure. It is important to discuss what to expect following the procedure with your Structural Heart Team.

Will I be able to feel the MitraClip implant in my heart?
No, you will not be able to feel the implant.

Will I be prescribed any medications following the MitraClip procedure?
Your doctor or nurse will give you instructions about your medications before you leave the hospital.

Who should not have the MitraClip procedure?
Your doctor may decide that the MitraClip procedure is not appropriate for you if you:
  • Cannot tolerate medications that thin the blood or prevent blood clots from forming
  • Have an active infection or inflammation of the mitral valve
  • Have mitral valve disease as a result of rheumatic fever
  • Have a blood clot in your heart or in the vessels that carry blood from the lower body to the heart
  • Your doctor should discuss with you if you have any of these issues that would prevent you from having the MitraClip procedure. An evaluation of your heart will also confirm if your heart valve anatomy would allow for successful placement of the device.

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